胶质肉瘤的临床及MRI特点分析  

Analysis of MRI and clinical characteristics of gliosarcoma

作　　者：李锐 张茂柏[1] 李志兵[1] 梁廷宇 霍恺 乔志刚[1] 于春海[2] LI Rui;ZHANG Mao-bai;LI Zhi-bing(Department of Neurosurgery,Shanxi Tumor Hospital,Taiyuan 030000,China)

机构地区：[1]山西省肿瘤医院神经外科,太原030000 [2]山西省肿瘤医院核磁CT室,太原030000

出　　处：《临床神经外科杂志》2018年第5期358-361,共4页Journal of Clinical Neurosurgery

摘　　要：目的探讨胶质肉瘤的MRI及临床特点。方法回顾性分析山西省肿瘤医院2012年3月至2018年1月,经手术切除病理证实的6例胶质肉瘤患者的临床资料。并对相关文献进行复习。结果 6例患者术前均行MRI平扫及增强扫描,病变均为单发,且位于小脑幕上。其中2例额叶、1例颞叶及1例顶枕叶病变均为混杂信号,呈囊实性病变,瘤周有明显水肿信号影;增强扫描病灶呈不规则强化。2例颞叶病变呈等长T1稍长T2混杂信号,DWI呈高信号,增强扫描不均匀强化,肿瘤外侧缘与邻近硬脑膜相贴,下缘可见脑膜尾征。6例患者术前表现为头痛、恶心、呕吐等高颅压症状,局灶性神经功能障碍,癫痫发作等,病程为11 d～6个月。患者均行手术治疗,其中5例患者肿瘤全切除,1例患者肿瘤次全切除。术后病理检查均证实为胶质肉瘤。术后6例患者均行常规放射治疗,4例患者行化疗。结论胶质肉瘤是一种恶性程度较高的肿瘤,根据其MRI和临床特点术前难以确诊,手术切除病理检查是其主要的诊断方式,手术切除是目前治疗胶质肉瘤的主要方法。Objective To explore the MRI and clinical features of gliosarcoma. Methods The clinical data of 6 patients with gliosarcoma confirmed by pathology in Shanxi Tumor Hospital from March 2012 to January 2018 were analyzed retrospectively, and parallel literature was reviewed. Results Lesions in 6 patients were single by preoperative MRI enhancement and above the tentorium,including 2 cases of frontal lobe, 1 case of temporal lobe, and 1 case of occipital lobe lesions which were with mixed signals, saccate solid lesions, obvious edema around tumors. Signal enhancement scanning showed irregular reinforcement. In the 2 cases, the temporal lobe presented mixed signals of equal length T1 and slightly longer T2 ,while the DWI presented high signals. Uneven enhancement was seen in the enhanced scanning. Six patients presented with headache, nausea, vomiting and other high cranial pressure symptoms, focal neurologic dysfunction, seizures, etc. Their medical history ranged from 11 d to 6 months. In 5 cases, total tumor resection and 1 case of subtotal tumor resection were confirmed to be gliosarcoma by postoperative pathological examination. All the 6 patients underwent routine radiotherapy and 4 chemotherapy. Conclusions Gliosarcoma is a highdegree of malignant tumors, according to its characteristics and clinical features of preoperative MRI is difficult to diagnosis, surgical removal of the pathologic examination is the main way of diagnosis. Surgical treatment is the main method for the treatment of gliosarcoma.

关 键 词：胶质肉瘤 MRI特点 临床特点 手术切除 

分 类 号：R739.41[医药卫生—肿瘤]